Sudden Shoulder pain – the ins and outs

It is true to say we don’t appreciate how precious our shoulder joint is, and how much we use it until something goes wrong with it!  It is also the most mobile and flexible joint in the human body. The particular ball and socket joint structure allow a lot of flexibility, but the downside of this is an unstable joint. For this reason, shoulder stiffness and sudden shoulder pain is such a common complaint. Precisely because the shoulder joint has such freedom of movement, it can often go into positions that induce stress on the muscles, in and around the joint.

Shoulder Physiology

In order to understand shoulder pain, it is first important to understand the structure and working mechanisms of this joint.   

The clavicle (collar bone), is a long, curved bone that connects with the scapula and sternum (breast bone). It attaches the upper arm to the body and provides support which enables flexibility and free movement of the shoulder.

The scapula (shoulder bone) is a flat, triangular shaped bone that connects to the humerus (upper arm bone) and the clavicle. The humerus runs from the shoulder to the elbow. The head of the humerus fits into the glenoid cavity of the scapula to form the shoulder joint, alternatively known as the glenohumeral joint.  

Within the shoulder joint, and acting as a cushion, there are several synovial bursae – fluid-filled sacs.  

Other components of the shoulder joint which help with the stability of the joint are

Rotator cuff muscles: This important group of muscles surrounding the shoulder joint is attached to the humerus. These muscles help hold the head of the humerus in the glenoid cavity, aiding joint stability.

Causes of shoulder pain and when to seek medical help

Frozen shoulder (adhesive capsulitis)– this is a painful condition that greatly reduces mobility in the joint. Pain is followed by stiffness, wherein severe cases, movement is completely blocked. This type of disorder can present as shoulder pain without injury leaving the patient wondering what this shoulder pain for no reason could be or what could be causing it. When a patient has a frozen shoulder, it starts with the capsule (a loose soft tissue which covers the ball and socket joint) becoming irritated, causing pain. The shoulder will gradually begin to show symptoms, which get worse over time.

Sometimes it is harder to get to the cause of this problem because damage builds over time, however,  shoulder pain no injury needs expert medical attention to get a proper pain-management and treatment plan.

Rotator cuff disease– the group of muscles and tendons which surround the shoulder and help to keep it stable are often overworked and are therefore prone to injury or inflammation. Problems associated with the rotator cuff are commonly linked to sudden trauma to the shoulder, often during a contact sport, which may have happened many years before. However, like many injuries to the shoulder, this common shoulder disorder can be due to wear and tear and is frequently seen in patients whose work involves repetitive overhead movement or lifting their arm overhead. If you feel shoulder pain (be it sudden left shoulder pain or sudden right shoulder pain), you should seek specialized orthopedic consultation for this type of injury, which will assess the extent of injury and treatment plan necessary.

Shoulder Dislocation happens when the ball part of the joint actually moves out of the socket. This usually happens due to a sudden impact, for example, a fall, or a football tackle, and will provoke a sudden sharp pain in the shoulder. This shoulder injury needs immediate medical attention and an orthopedic surgeon or physiotherapist will be able to expertly reinsert the dislocated shoulder. The sudden severe shoulder pain felt by the sufferer will almost totally disappear once the shoulder has been put back in place.

 

Treatment for shoulder pain

Unfortunately for some, shoulder problems can be long-term with many sufferers still having symptoms after several months. Thankfully there are many treatment options available for sudden shoulder pain – the main ones include:

1. Oral medication

Nonsteroidal anti-inflammatory drugs(NSAIDs)– some of which can be bought without a prescription can help ease inflammation and pain. They help to reduce swelling within the shoulder joint. Other medicines such as corticosteroids are quick acting and provide pain relief to the sufferer. This type of medicine contains steroids and help reduce swelling and pain. Analgesics are probably the most commonly prescribed drugs for pain reduction and have positive effects for the sufferer.  

As with all medicines always follow the instructions on the pack making sure the medicine is suitable for you and that you limit yourself to the right dosage.

2. Injections

Your orthopedic surgeon may suggest injections as part of your treatment plan for shoulder pain. The most common type used is corticosteroids. This synthetic drug, (which resembles the hormone cortisol, naturally produced in our body) is a powerful anti-inflammatory that can be injected directly into the shoulder giving quick, easy, safe relief for many shoulder disorders.

3. Physiotherapy

A very effective way of promoting healing is physiotherapy. A physiotherapist will use a variety of treatments, depending on your specific problem, some of which may include:

  • Massage–  manipulation of the shoulder area using their hands and expertise.
  • Transcutaneous electrical nerve stimulation (TENS)– small, electrical pads are placed on your skin around the shoulder area.  Light pulses of electricity help reduce pain.
  • Laser light therapy– laser is used to relieve pain and is a safe, painless, effective way for treating various shoulder disorders.

4.  Rest

Depending on the cause of your shoulder discomfort, your medical practitioner might recommend that you avoid doing certain activities. A careful balance needs to be reached, however, because complete inactivity may make symptoms worse so some, not all, movement should be reduced. Always seek advice from your orthopedic surgeon or physiotherapist as to what exercises are safe for you to do.

Sudden Shoulder Pain Prevention

Sometimes, when we start a physical activity, sudden shoulder pain without injury can be a cause for alarm. Stiffness of the joint is common if carrying out an activity that hasn’t been done for a while. One way to prevent sudden shoulder pain is by simply warming up before any physical activity. If you have not been exercising for a while, as well as warming up, you should build up gradually – listen to your body. If doing a 60-minute workout is your goal, start with 20 minutes, then 30 minutes, until you feel comfortable.

If you have sudden shoulder pain in your left shoulder or sudden right shoulder pain during certain exercises, but know that you haven’t injured it through trauma, then you are most likely suffering from repetitive strain injury (RSI). What starts off as a minor, niggling pain can turn into a debilitating problem taking months to heal. To prevent further pain or damage the simple remedy is rest. Take time away from the activity that is causing the pain. Luckily this doesn’t mean stopping altogether, light activity can still be carried out while avoiding the activity that causes the pain.

If you notice a frequent occurrence of sudden onset shoulder pain or find yourself asking “why is my shoulder hurting” then it may be time for you to give the best orthopedic surgeon in your area a call. Dr. Daniel Schwartz specializes in shoulder and elbow injury treatment and you will be guaranteed personal care from him from your first visit until your last. Dr. Schwartz prides himself on looking after each patient with care and expertise, which he has built up over his years of experience in orthopedic surgery and will find the best treatment for you. If you would like to have more information or book an appointment for a first consultation, please call and we will be delighted to assist you or click here to send an email.